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Risk factors associated with peritoneal-dialysis-related peritonitis.

Kerschbaum J, König P, Rudnicki M - Int J Nephrol (2012)

Bottom Line: Results.The following nonmodifiable risk factors were considered valid and were associated with an increased risk of peritonitis: ethnicity, female gender, chronic lung disease, coronary artery disease, congestive heart failure, cardiovascular disease, hypertension, antihepatitis C virus antibody positivity, diabetes mellitus, lupus nephritis or glomerulonephritis as underlying renal disease, and no residual renal function.Discussion.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.

ABSTRACT
Background. Peritonitis represents a major complication of peritoneal dialysis (PD). The aim of this paper was to systematically collect data on patient-related risk factors for PD-associated peritonitis, to analyze the methodological quality of these studies, and to summarize published evidence on the particular risk factors. Methods. Studies were identified by searches of Pubmed (1990-2012) and assessed for methodological quality by using a modified form of the STROBE criteria. Results. Thirty-five methodologically acceptable studies were identified. The following nonmodifiable risk factors were considered valid and were associated with an increased risk of peritonitis: ethnicity, female gender, chronic lung disease, coronary artery disease, congestive heart failure, cardiovascular disease, hypertension, antihepatitis C virus antibody positivity, diabetes mellitus, lupus nephritis or glomerulonephritis as underlying renal disease, and no residual renal function. We also identified the following modifiable, valid risk factors for peritonitis: malnutrition, overweight, smoking, immunosuppression, no use of oral active vitamin D, psychosocial factors, low socioeconomic status, PD against patient's choice, and haemodialysis as former modality. Discussion. Modifiable and nonmodifiable risk factors analyzed in this paper might serve as a basis to improve patient care in peritoneal dialysis.

No MeSH data available.


Related in: MedlinePlus

Process of identification of eligible studies. *16 studies: not on all-cause peritonitis; 21 studies: no patient risk factors, 6 studies: cohorts including children; 5 studies: cohorts < 40 patients; 1 study: single event report.
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fig1: Process of identification of eligible studies. *16 studies: not on all-cause peritonitis; 21 studies: no patient risk factors, 6 studies: cohorts including children; 5 studies: cohorts < 40 patients; 1 study: single event report.

Mentions: The search identified 415 potentially relevant studies. First, 112 articles had to be excluded because they were no study on peritonitis of any cause. Then, 303 abstracts were screened and 3 articles were additionally identified through the references of the former identified articles. In a next step, 93 full-text articles were selected for detailed analysis, 49 articles had to be excluded due to the predefined exclusion criteria. Finally, 44 studies were assessed for methodological quality. Nine articles were excluded because of having low methodological scoring and finally, thirty-five studies were scored as having “acceptable” methodological quality. Selection process is depicted in Figure 1, characteristics of studies are shown in Table 2. Risk factors were divided into nonmodifiable and modifiable factors, a brief overview is shown in Figure 2.


Risk factors associated with peritoneal-dialysis-related peritonitis.

Kerschbaum J, König P, Rudnicki M - Int J Nephrol (2012)

Process of identification of eligible studies. *16 studies: not on all-cause peritonitis; 21 studies: no patient risk factors, 6 studies: cohorts including children; 5 studies: cohorts < 40 patients; 1 study: single event report.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539329&req=5

fig1: Process of identification of eligible studies. *16 studies: not on all-cause peritonitis; 21 studies: no patient risk factors, 6 studies: cohorts including children; 5 studies: cohorts < 40 patients; 1 study: single event report.
Mentions: The search identified 415 potentially relevant studies. First, 112 articles had to be excluded because they were no study on peritonitis of any cause. Then, 303 abstracts were screened and 3 articles were additionally identified through the references of the former identified articles. In a next step, 93 full-text articles were selected for detailed analysis, 49 articles had to be excluded due to the predefined exclusion criteria. Finally, 44 studies were assessed for methodological quality. Nine articles were excluded because of having low methodological scoring and finally, thirty-five studies were scored as having “acceptable” methodological quality. Selection process is depicted in Figure 1, characteristics of studies are shown in Table 2. Risk factors were divided into nonmodifiable and modifiable factors, a brief overview is shown in Figure 2.

Bottom Line: Results.The following nonmodifiable risk factors were considered valid and were associated with an increased risk of peritonitis: ethnicity, female gender, chronic lung disease, coronary artery disease, congestive heart failure, cardiovascular disease, hypertension, antihepatitis C virus antibody positivity, diabetes mellitus, lupus nephritis or glomerulonephritis as underlying renal disease, and no residual renal function.Discussion.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.

ABSTRACT
Background. Peritonitis represents a major complication of peritoneal dialysis (PD). The aim of this paper was to systematically collect data on patient-related risk factors for PD-associated peritonitis, to analyze the methodological quality of these studies, and to summarize published evidence on the particular risk factors. Methods. Studies were identified by searches of Pubmed (1990-2012) and assessed for methodological quality by using a modified form of the STROBE criteria. Results. Thirty-five methodologically acceptable studies were identified. The following nonmodifiable risk factors were considered valid and were associated with an increased risk of peritonitis: ethnicity, female gender, chronic lung disease, coronary artery disease, congestive heart failure, cardiovascular disease, hypertension, antihepatitis C virus antibody positivity, diabetes mellitus, lupus nephritis or glomerulonephritis as underlying renal disease, and no residual renal function. We also identified the following modifiable, valid risk factors for peritonitis: malnutrition, overweight, smoking, immunosuppression, no use of oral active vitamin D, psychosocial factors, low socioeconomic status, PD against patient's choice, and haemodialysis as former modality. Discussion. Modifiable and nonmodifiable risk factors analyzed in this paper might serve as a basis to improve patient care in peritoneal dialysis.

No MeSH data available.


Related in: MedlinePlus